Organization Active NPI

Genesis Physical Therapy and Wellness, LLC

  • Physical Therapist
  • Thibodaux, LA
National Provider Identifier
1821553397
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GENESIS PHYSICAL THERAPY AND WELLNESS, LLC
Practice address
1003 Saint Mary St
Thibodaux, LA 70301-6624
Phone
(985) 227-9116
Fax
(985) 227-9259
NPI assigned
Feb 8, 2019
Last updated
Apr 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leo Hebert
Title
Billing Manager
Phone
(985) 447-7905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1003 Saint Mary St
Thibodaux, LA 70301-6624

Mailing address

PO Box 1137
Thibodaux, LA 70302-1137
Phone (985) 447-7905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190613000056 LA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5193058733 Receives reassigned benefits from 2 practitioners
Practice locations: Thibodaux, LA

National Provider Directory

National Provider Directory

Locations

1000 Plantation Rd
Ste A
Thibodaux, LA 70301
Phone (985) 414-0586

1003 Saint Mary St
Thibodaux, LA 70301
Phone (985) 227-9116

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1821553397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703021137",
            "telephone_number": "985-447-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 SAINT MARY ST",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703016624",
            "telephone_number": "985-227-9116",
            "fax_number": "985-227-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS PHYSICAL THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-08",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "985-447-7905"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.